=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801861539
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PEDRO OYOLA NIEVES M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/17/2006
-----------------------------------------------------
Last Update Date | 01/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 73 EDIFICIO MEDICO SANTA CRUZ CALLE SANTA CRUZ SUITE 416
-----------------------------------------------------
City | BAYAMON
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00959-0000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-786-7460
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PMB 170 FOREST HILLS A8 CALLE MARGINAL
-----------------------------------------------------
City | BAYAMON
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00959-0000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-399-0884
-----------------------------------------------------
Fax | 787-786-7460
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 6157
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------